Designing with dissemination in mind: Development and evaluation of a theory-based physical activity intervention using the Multiphase Optimization Strategy

项目摘要/摘要 坚持规定的健康行为的困难显著阻碍了生活方式体重的长期好处 管理计划，导致心血管疾病(CVD)和早期死亡的风险增加。 尽管体力活动(PA)是持续减肥的最佳预测因素之一，但长期坚持体力活动 参加生活方式体重管理计划的超重或肥胖成年人仍然贫穷。缺席 可访问的、有效的、基于理论的、考虑到每个人的价值观和偏好的计划仍然是 主要障碍。因此，迫切需要新颖的、以人为中心的、可扩展的干预措施来有效地 在超重或肥胖的成年人中促进PA的依从性，以增强减肥维持和心血管疾病 预防。K01职业发展奖的总体目标是扩大和试验一个理论- 基于PA计划(称为Move+)，旨在增强注册的超重或肥胖成年人的动机 在一个生活方式的体重管理计划中。首先，我将让利益相关者评估以下内容的初步可接受性 移动+干预组件。以用户为中心的设计测试将分两个周期进行：1)初始利益相关者 审查Move+组件设计和内容，以及2)为期12周的单臂现场试验，以试行 Move+计划。其次，我将评估在现有生活方式体重范围内提供Move+的可行性 管理程序(防止T2)。我将招募80名体重指数为25-45公斤/平方米的成年人接受6个月的治疗(其中12人 一个月的跟踪)远程交付预防T2计划，与Move+计划集成。要隔离 哪些Move+组件是有效成分，我将采用多阶段优化策略和 进行整群随机2^3全析因试验。将随机抽取8组n=10名参与者 指定给3个移动+组件的组合。我的长期目标是发展一项独立的研究 该计划的重点是预防和治疗慢性疾病，包括肥胖和心血管疾病，由 设计和传播以理论为基础的、优化的PA干预措施，以促进持续的行为改变。 与我的导师团队(Catenacci博士、马斯特斯博士、关颖珊博士、康罗伊博士、帕米马特博士、派尔博士和巴纳德女士)一起， 我已经制定了一个全面的培训计划来支持这一职业目标。我的主要培训目标包括 培养以下方面的专业知识：1)行为改变理论在PA干预设计中的应用；2)传播 和实施科学，3)使用新的框架和有效的试验设计，以及4)人类临床 试验设计和实施。我过去的经验，加上我的专家指导团队，一次强有力的培训 计划和特殊的环境(科罗拉多大学安舒茨医学院)将确保我的 成功。该K01的完成将产生支持竞争性R01所需的关键初步数据 应用，将既是一个极好的培训机会，也是一个原创和有意义的科学 我的事业目标是成为PA和肥胖症研究领域的新兴领导者。

PROJECT SUMMARY/ABSTRACT Difficulty adhering to prescribed health behaviors significantly hinders the long-term benefits of lifestyle weight management programs, leading to an increased risk of cardiovascular disease (CVD) and early mortality. Although physical activity (PA) is one of the best predictors of sustained weight loss, long-term adherence to PA remains poor in adults with overweight or obesity enrolled in lifestyle weight management programs. Absence of accessible, effective, theory-based programs that account for each person’s values and preferences remains a major barrier. Thus, novel, person-centered, and scalable interventions are urgently needed to effectively promote PA adherence in adults with overweight or obesity to enhance weight loss maintenance and CVD prevention. The overall objective of this K01 Career Development Award is to expand and pilot test a theory- based PA program (called MOVE+) designed to enhance motivation in adults with overweight or obesity enrolled in a lifestyle weight management program. First, I will engage stakeholders to assess the initial acceptability of the MOVE+ intervention components. User-centered design testing will occur over 2 cycles: 1) initial stakeholder review of MOVE+ component design and content, and 2) a 12-week, single-arm field trial to pilot test delivery of the MOVE+ program. Second, I will evaluate the feasibility of delivering MOVE+ within an existing lifestyle weight management program (Prevent T2). I will recruit 80 adults with BMI 25-45 kg/m2 to receive 6 months (with 12 month follow-up) of remote delivery of the Prevent T2 program, integrated with the MOVE+ program. To isolate which MOVE+ components are “active ingredients”, I will employ the Multiphase Optimization Strategy and conduct a cluster randomized 2^3 full factorial pilot trial. Eight clusters of n=10 participants will be randomly assigned to a combination of 3, MOVE+ components. My long-term goal is to develop an independent research program that focuses on the prevention and treatment of chronic diseases, including obesity and CVD, by designing and disseminating theory-based, optimized PA interventions that promote sustained behavior change. Along with my mentorship team (Drs. Catenacci, Masters, Kwan, Conroy, Pfammatter, Pyle, and Ms. Barnard), I have developed a comprehensive training plan to support this career goal. My primary training goals include to develop expertise in: 1) the application of behavior change theory to PA intervention design, 2) dissemination and implementation science, 3) the use of novel frameworks and efficient trial designs, and 4) human clinical trial design and conduct. My past experience, complemented by my expert mentoring team, a robust training plan, and an exceptional environment (the University of Colorado Anschutz Medical Campus) will ensure my success. Completion of this K01 will generate critical preliminary data needed to support a competitive R01 application and will serve as both a superb training opportunity and as an original and meaningful scientific contribution to propel my career goal of becoming an emerging leader in PA and obesity research.